title: Intracardiac echocardiography guided transeptal catheter injection of microspheres for assessment of cerebral microcirculation in experimental models.
abstract: The use of microspheres for the determination of regional microvascular blood flow (RMBF) has previously used different approaches. This study presents for the first time the intracardiac injection of microspheres using transeptal puncture under intracardiac echocardiography guidance. Five Merino sheep were instrumented and cardiovascularly supported according to local guidelines. Two catheter sheaths into the internal jugular vein facilitated the introduction of an intracardiac probe and transeptal catheter, respectively. Five million colour coded microspheres were injected into the left atrium via this catheter. After euthanasia the brain was used as proof of principle and the endpoint for determination of microcirculation at different time points. Homogeneous allocation of microspheres to different regions of the brain was found over time. Alternate slices from both hemispheres showed the following flow ranges: for slice 02; 0.57-1.02 mL/min/g, slice 04; 0.45-1.42 mL/min/g, slice 06; 0.35-1.87 mL/min/g, slice 08; 0.46-1.77 mL/min/g, slice 10; 0.34-1.28 mL/min/g. A mixed effect regression model demonstrated that the confidence interval did include zero suggesting that the apparent variability intra- and intersubject was not statistically significant, supporting the stability and reproducibility of the injection technique. This study demonstrates the feasibility of the transeptal injection of microspheres, showing a homogeneous distribution of blood flow through the brain unchanged over time and has established a new interventional model for the measurement of RMBF in ovine models.
authors.affiliation: Intensive Care Department, Royal Brisbane and Women's Hospital, Burns-Trauma & Critical Care Research Centre, The University of Queensland, Herston, QLD 4025, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Bellapart
authors.forename: Kimble R
authors.initials: KR
authors.lastname: Dunster
authors.forename: Sara
authors.initials: S
authors.lastname: Diab
authors.forename: David G
authors.initials: DG
authors.lastname: Platts
authors.forename: Christopher
authors.initials: C
authors.lastname: Raffel
authors.forename: Levon
authors.initials: L
authors.lastname: Gabrielian
authors.forename: Marc O
authors.initials: MO
authors.lastname: Maybauer
authors.forename: Adrian
authors.initials: A
authors.lastname: Barnett
authors.forename: Robert James
authors.initials: RJ
authors.lastname: Boots
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser